Colon cancer is one of the most common types of cancer, the third most common type worldwide. It is a type of malignant tumor, and the incidence and mortality rate associated with colon cancer is very high. In 2020, the incidence of colon cancer was 10%, and the associated mortality rate was 9.4%. Most cases of colon cancer are caused by lifestyle and aging, but also by genetic factors, dietary habits and the intestinal microbiome.
Risk factors for Colon Cancer
Understanding risk factors is crucial for prevention. These include:
- Chronic constipation : can cause colon cancer, may indicate the presence of serious intestinal problems, including tumors that block the intestine.
- Older age : The risk increases significantly after age 50.
- Family history : Genetic instability is a key factor in the pathogenesis of colon cancer. There are three main types of genomic instability: chromosomal instability, microsatellite instability, and aberrant DNA methylation. These processes lead to the gradual accumulation of mutations in tumor suppressor genes and proto-oncogenes.85
- Unhealthy diet : Diet plays an important role in the risk of colon cancer. Increased intake of calcium and vitamin D may reduce the risk of colon cancer, while excessive consumption of red and processed meat may increase it. Dietary fiber and whole grains also have a positive effect in cancer prevention.
- Sedentary lifestyle : Lack of regular physical activity (gymnastics, walking) is associated with an increased risk.
- Obesity : Obesity is associated with chronic inflammation and increases the risk of colon cancer. Inflammation causes an increase in inflammatory factors, such as TNF-α, IL-1, and IL-6, which may contribute to the development of colon cancer.
- Alcohol consumption and smoking : These habits are linked to an increased risk of colon cancer.
- Inflammatory bowel disease : People with conditions such as ulcerative colitis or Crohn's disease are at increased risk.
Colon Cancer Treatment
Conventional treatments for colon cancer include surgery, chemotherapy, and radiation therapy. Surgery is indicated for patients with early, localized colonic lesions, with a good recovery rate. Chemotherapy is used primarily for metastatic cancer, and radiation therapy uses ionizing radiation to inhibit the multiplication of malignant cells. A newer treatment method is immunotherapy, which has proven its effectiveness in clinical trials, especially for patients with microsatellite instability-high (MSI-H).
Colon cancer prevention strategies
- Regular screening : Regular screening is essential for early detection of colon cancer. Common screening methods include:
- Colonoscopy : Recommended starting at age 50, a colonoscopy allows the doctor to view the inside of the colon and remove polyps before they become cancerous.
- Fecal occult blood tests : These tests detect the presence of blood in the stool, a possible sign of colon cancer.
- Flexible sigmoidoscopy : Similar to colonoscopy, but only examines the lower part of the colon.
- Adopting a healthy diet: A balanced diet can significantly reduce the risk of colon cancer. Recommendations include:
- High fiber intake : Vegetables, fruits, whole grains, and legumes are excellent sources of fiber that help maintain healthy bowel movements.
- Reducing your intake of red and processed meat : Limiting these foods may decrease your risk of colon cancer.
- Consuming foods rich in calcium and vitamin D : Dairy products, fish, and eggs are good sources of calcium and vitamin D, which may have a protective effect on the colon.
- Maintaining an active lifestyle : Regular physical activity helps maintain a healthy body weight and reduces the risk of colon cancer. It is recommended:
- Aerobic exercise : Activities such as walking, running, cycling, or swimming for at least 150 minutes per week.
- Strength training : Resistance exercises at least twice a week.
- Maintaining a healthy weight : Obesity is a major risk factor for colon cancer. Losing weight through diet and exercise can reduce your risk.
- Avoiding alcohol and smoking : Limiting alcohol consumption and quitting smoking are essential for preventing colon cancer and other types of cancer.
- Consuming Probiotics and Prebiotics : Probiotics and prebiotics help maintain a healthy gut microbiome, which may reduce the risk of colon cancer. Probiotics, found in foods like yogurt and kefir, and prebiotics, found in fiber-rich foods, are essential for gut health.
Probiotics and their role in preventing Colon Cancer
Probiotics are live microorganisms, especially bacteria, that confer a health benefit to the host when consumed in adequate amounts. The most common probiotics include Lactobacillus and Bifidobacterium species. These beneficial bacteria help to:
- Improving the intestinal barrier : Probiotics can strengthen the intestinal barrier, preventing pathogens and toxins from passing into the bloodstream, which may reduce the risk of chronic inflammation, a known risk factor for colon cancer.
- Regulation of the immune system : Probiotics positively influence the immune response, stimulating the production of antibodies and immune cells that can destroy incipient cancer cells.
- Production of anticarcinogenic substances : Some probiotics can produce short-chain fatty acids, such as butyrate, which has anti-inflammatory and anticarcinogenic properties.
- Reducing treatment side effects : Probiotics may help alleviate the side effects of chemotherapy and radiation therapy by helping to maintain a balanced gut microbiome.
Prebiotics and their role in colon cancer prevention
Prebiotics are non-digestible food components that selectively stimulate the growth and/or activity of certain beneficial bacteria in the gut. The benefits of prebiotics include:
- Stimulating the growth of beneficial bacteria : Prebiotics promote the growth and activity of probiotic bacteria, contributing to a balanced and healthy intestinal microbiome.
- Fermentation and production of beneficial substances : In the colon, prebiotics are fermented by beneficial bacteria, resulting in the production of short-chain fatty acids, such as butyrate, which has protective effects against colon cancer.
- Improving intestinal transit : Prebiotics help maintain healthy intestinal transit, reducing the risk of constipation and, therefore, prolonged exposure of the colon mucosa to potentially carcinogenic substances.
- Modulating inflammation : By stimulating the production of short-chain fatty acids and reducing colonic pH, prebiotics may help reduce inflammation, a major risk factor for the development of colon cancer.
Prebiotics, when administered alone or in combination with probiotics, have the potential to prevent tumor formation, as demonstrated in animal and human studies. The antiproliferative effects of prebiotics have been demonstrated in vivo in rodents by inhibiting the formation of aberrant crypt foci and colonic polyps, as well as changes in gene expression, such as increased pro-apoptotic Bax, Caspase 3 and Caspase 9 and decreased expression of anti-apoptotic Bcl-2 and Survivin in vitro in cells.
Prebiotics have also been shown to alter bacterial concentrations in both in vivo animal tests and in vitro human tests, increasing levels of beneficial bacteria such as Lactobacillus, Bifidobacterium, and Bacteroides, while decreasing levels of harmful bacteria such as Clostridium spp., as well as harmful enzymes such as nitroreductase, ß-glucuronidase, and azoreductase. Prebiotics are not only beneficial in preventing the development of colorectal cancer, but have also been shown to be favorable in improving symptoms in those affected by the disease. ( source )
Colon cancer prevention is possible through a combination of regular screening, adopting a healthy lifestyle, maintaining a balanced diet, and avoiding known risk factors. Awareness and education of the population on these preventive measures are essential for reducing the incidence and mortality caused by colon cancer.
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